General characteristics of the disease.
Salpingitis is a gynecological disease caused by inflammation of one or both fallopian tubes. With a combined inflammatory process in the fallopian tubes, ligaments and ovaries, the disease is called salpingoophoritis or adnexitis.
The development of salpingitis most often provokes a pathogenic bacterial infection. Infection, usually upward: from the uterus to the fallopian tube, and only then into the ovaries or ligamentous apparatus.
Inflammatory exudate, accumulated with salpingitis, leads to tissue scarring and partial or complete obstruction of fallopian tubes. As a result of this pathological process, a woman can become barren.
With acute salpingitis in the fallopian tubes, women can develop purulent or serous cavities. They can cause an ovarian abscess, spread the infection to the peritoneum and provoke inflammation of the pelvic organs and intercigitic abscess.
Chronic salpingitis is one of the most frequent causes of female infertility. Chronic inflammatory process in the fallopian tubes trigger infections transmitted during sexual intercourse: ureaplasmas, chlamydia, mycoplasmas, trichomonads, etc. Possible sources of infection in chronic salpingitis are also – contraceptive spirals, abortion, miscarriage, any diagnostic and therapeutic actions inside the uterus.
Symptoms of salpingitis.
The main symptoms of salpingitis at the initial stage of the disease are pain and urination disorders. A woman with symptoms of salpingitis feels a pulling pain in the lower abdomen and frequent false urges to urinate.
At the next stage of the disease, the symptom of salpingitis is the appearance of a copious purulent vaginal secretion. During sexual intercourse, a woman experiences severe pain. Acute salpingitis manifests itself by sharp pain not only in the peritoneum, but also in the lumbar region. Symptoms of salpingitis of acute form include also high body temperature.
In chronic salpingitis, the temperature is subfebrile, and the pain syndrome is of low intensity. At the stage of chronic salpingitis, violations of the menstrual cycle always develop.
Diagnosis of salpingitis.
Diagnosis of the disease is complicated by the similarity of symptoms of acute salpingitis with appendicitis or ectopic (ectopic) pregnancy. Sharp pain and muscle spasm often does not allow the doctor to obtain objective information about the patient’s condition.
Typical salpingitis symptoms during palpation during a gynecological examination are the soreness of the cervix and the sensitivity of the appendages.
Indicators of ESR in blood tests for purulent acute salpingitis 15mm / h, leukocytosis is observed above 10.5 thousand ultrasound confirms the presence of inflammatory processes in the fallopian tubes, and for the identification of the causative agent of salpingitis it is necessary to use puncture of the fallopian tube or the posterior fornix.
Laparoscopic method of sampling material for acute salpingitis is the most informative. Its reliability is more than 78%. However, because of the high cost and traumatism of this method, it is used only in the most severe cases of acute salpingitis.
Treatment of salpingitis.
The tactics of treating salpingitis depends on the stage and nature of the course of the disease.
The early onset of antibacterial treatment for acute salpingitis allows significant results to be achieved as early as 7-10 days and prevent the degeneration of the disease into chronic salpingitis.
Self-treatment of salpingitis of any form is unacceptable. It can lead to irreversible organic changes in the fallopian tubes, to the need for surgical intervention and to hard-to-treat infertility.
Surgical treatment of salpingitis is used with tumors found in the fallopian tubes, whose structure is similar to a tumor. The use of surgical treatment of salpingitis is also necessary for adhesions in the fallopian tubes and the woman’s desire to become pregnant, or in the case of hydrosalpinx formation. The latter is the accumulation of fluid between the spikes of the uterine tube.
Most often in the surgical treatment of salpingitis are used laparoscopic operations. Thanks to them, virtually all the pathologies of the fallopian tubes can be eliminated. At the same time, this type of operation does not provoke the formation of new adhesions, is not very traumatic and aesthetic. When minilaparoscopic treatment of salpingitis on the woman’s belly, only a few punctures are made.
During the operation, resection of the tube tissues with spikes is carried out, the purulent secret is removed, disinfection of the walls of the fallopian tubes is carried out, drainage is established.
After laparoscopic treatment of salpingitis, a woman can leave the hospital on the third day. The rehabilitation period lasts about 2 weeks. However, it is recommended for a woman to give up a sexual life within one month and undergo a gynecological examination every 3 months.